Climate change is expected to result in more frequent, more intense, and longer heat waves. Identification of vulnerable populations to heat-related health impacts is of critical importance for climate change adaptation planning and implementation. We hypothesize that significant differences in vulnerability to heat-related health risks exist between urban and rural communities. To test this hypothesis we will 1) Develop a spatially explicit model defining vulnerable populations during extreme heat events in an urban (Birmingham) versus rural (Black Belt) community in Alabama over the past 20 years, 2) Use regional climate model forecasting and outputs from exposure-response model results to determine the likelihood of extreme heat event related health impacts in Birmingham and Black Belt communities over the next 20 years, and 3) In collaboration with local public health officials and community organizations working with particularly underserved urban and rural communities, prioritize heat-related health issues and develop a planning strategy to most effectively reach identified vulnerable populations. The proposed investigation will contribute to climate change adaptation research by identifying the specific public health needs and priorities of an urban versus rural community. Spatially explicit vulnerability maps that apply land data assimilation systems and daily satellite observations will inform community prioritization and planning to decrease risk of heat related mortality and morbidity. The project will establish collaborations that bridge diverse research disciplines and local level government and community organizations. Building these collaborations and developing tools for local level prioritization based on vulnerability analysis will allow for development of an in-depth RO1 research plan designed to implement and test the effectiveness of adaptation strategies in particularly vulnerable communities in the Deep South. PUBLIC HEALTH RELEVANCE: Increasing evidence suggests effective strategies for adaptation to climate change will require community level public health interventions. The proposed exploratory studies will determine whether significant differences in vulnerability to heat-related health impacts exist between underserved urban and rural communities. Positive findings would suggest delineation of unique urban and rural risk factors will lead to increased preparedness for extreme heat events.